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This paper aims to review the effectiveness of a Smoke‐free Homes Project in a deprived area, Salford, in the UK. The project aimed to reduce exposure to secondhand smoke within the home, chiefly amongst households with resident smokers.

Local people from ten deprived communities were recruited as Smoke‐free Advisors, raising awareness of the dangers of secondhand smoke and “rewarding” participants for making one of three smoke‐free promises, ranging from keeping their home smoke‐free (gold promise) to not smoking around children.

In nine months, the project more than doubled its original target of 1,440 smoke‐free households, achieving 3,261 smoke‐free promises. Three‐quarters of these were the full, “gold” promise. At follow up, 98 per cent claimed they had kept to their promise, with 72 per cent describing this as “fairly easy” or “very easy”. Most common reasons given for signing up were children's health or meeting a Smoke‐free Advisor. The target for 50 per cent of promises to come from households with at least one smoker was narrowly missed: 47 per cent was achieved. Although not directly targeting cessation, 81 per cent of smokers reported changes to their smoking habit: one‐quarter quitting, 14 per cent trying unsuccessfully, and 42 per cent cutting down.

Smoke‐free Homes Projects have much to contribute in terms of denormalising smoking in deprived areas.

Despite their popularity, Smoke‐free Homes Projects have rarely been evaluated for effectiveness. This project demonstrated that a three‐stage model using local people can reduce exposure to secondhand smoke, alongside smoking itself, in areas where smoking is often seen as “the norm”.

Scotland's smoke‐free legislation, introduced in March 2006, included an exemption for psychiatric hospitals. However, following the successful implementation of smoke‐free laws in almost all other workplaces in Scotland, important questions have been raised about why mental health facilities should be excluded. This study aimed to explore a move towards mental health settings becoming smoke‐free in Scotland by reviewing relevant literature, seeking the views of stakeholders and examining a number of case study hospitals who had recently or were in the process of going smoke‐free. The study found that stakeholders were overwhelmingly in favour of moving towards smoke‐free environments. Allowing smoking to continue in these settings when almost all other workplaces are smoke‐free was perceived as reinforcing the stigma attached to mental health, exacerbating inequalities in health, damaging the health of mental health professionals and potentially contributing to staff recruitment problems. Evidence from the international literature and from the case studies suggested that smoke‐free policies can be successfully implemented in mental health settings. This article discusses these findings and examines the factors that need to be considered if implementation is to be successful.

The purpose of this study is to review the barriers associated with implementing a campus‐wide smoke‐free policy as perceived by the American Cancer Society's Colleges against Cancer (CAC) Program chapter representatives.

Four focus group sessions were conducted at the annual CAC National Leadership Summit in October 2006. A total of 109 participants, or 41.4 percent of the total population of CAC member institutions, attended the focus groups.

All participants identified encountering barriers at some stage of the implementation process. Three major themes emerged when participants were asked to identify what they perceived to be the most significant barriers to successfully implementing a campus‐wide smoke‐free policy: lack of administrative and staff support, student involvement, and resources.

With the rising rate of smoking among college students and the release of the 2006 Surgeon General's report citing the harmful effects of secondhand smoke, the need for colleges and universities to take measures not only to curtail the number of smokers, but to limit the exposure to secondhand smoke is intensifying.

A study examining the challenges faced by colleges and universities when trying to implement a campus‐wide smoke‐free policy is absent from the literature. The paper helps in identifying the most significant barriers that may encourage efforts among colleges and universities to lessen or eliminate these barriers.

This paper aims to examine the level of smoke‐free policies in general hospitals and the barriers faced in implementing restrictive policies banning smoking inside buildings and on surrounding grounds.

A survey was developed to gather data on hospitals' current smoke‐free policies, including the challenges faced when implementing such a policy or the barriers to implementing one. The surveys were directed to the chief executive officers (CEOs) of Alabama general hospitals. Responses from 47 hospital CEOs, representing 46.5 percent of the total population were obtained.

Over one‐quarter of respondents were found to have restrictive smoke‐free policies. Of this group, over one‐third experienced a hostile response from employees that smoked. Nearly 85 percent indicated that they made smoking cessation resources available to their employees. Of those that did not have a restrictive smoke‐free policy, fear of employee and patient backlash was cited as the most common deterrent against implementing such a policy.

Studies show that restrictive smoke‐free workplace policies have altered employees' smoking prevalence and consumption. Given the recent reports on the dangers of secondhand smoke, hospitals should reduce the risk of exposure to secondhand smoke for employees, patients, and visitors. Furthermore, restrictive smoke‐free policies may help to increase hospitals' bottom line.

A study examining restrictive smoke‐free policies in general hospitals and challenges faced in implementing such policies is absent from the literature. Identifying the barriers faced may help health care facilities to avoid or overcome these barriers when implementing such policies. The paper addresses the issues involved.

The present research has three goals: to examine the prevalence of smoke‐free workplace policies; to examine how coverage by a smoke‐free workplace policy differs among racial/ethnic groups; and to examine the impact of smoke‐free workplace policy (SFWP) coverage on health outcomes.

The research uses secondary analysis of data from the Behavioral Risk Factor Surveillance System (BRFSS) from 1998‐2006.

It was found that SFWP coverage is below government goals – especially for Hispanic workers and that SFWP coverage was associated with health outcomes.

The relatively slow progress in coverage by smoke‐free workplace policies during the last eight years suggests the possibility that a ceiling has been reached in smoke‐free workplace policy coverage. Limitations include factors that might negatively influence SFWP reporting (e.g. lack of knowledge about SFWP; language barriers), availability of data after 2006, and a cross‐sectional design for health outcomes.

The findings suggest that there is health value in SFWP, but that coverage is not at 100 percent and a federal‐level mandate might be necessary to reach that level. In situations where customers are allowed to smoke, it may be more difficult to justify and enforce a smoke‐free workplace policy.

This is the first study to examine SFWP coverage by race over time. This study allows for examination of progress toward published SFWP goals.

To reduce the smoking rates and alleviate societal problems associated with smoking, health administrators and policy makers have attempted to promote and implement statewide smoking free policy. The present study examined how adults' awareness of and attitude toward the smoke-free air law, their perceived risks of secondhand smoke and current smoking status were associated with smoking attitude and behaviors.

As part of the Indiana Adult Tobacco Survey, 2,027 respondents participated in cross-sectional telephone surveys. A series of independent sample t-test and binary logistic regression analyses were performed.

Awareness of the state law was inversely related to negative attitude toward smoking behaviors. Individuals who reported favorable attitude toward the state smoke-free air law and higher risk perceptions of secondhand smoke showed negative attitude toward smoking behaviors. Non-smokers and former smokers were significantly different from current smokers with regard to attitude toward smoking. Negative attitude was significantly related to intention to quit smoking. Awareness of the state law, perceived risk and current smoking status were key determinants for anti-smoking attitude and behavior.

Findings highlight the importance of effective dissemination of the state law and recommend a strategic intervention design that invokes risk perceptions of secondhand smoke.

The study evaluated the impact on staff and patient advocates of the implementation of a smoke‐free policy covering buildings and grounds within a mental health trust. Findings show that early consultation is central to the ownership of smoke‐free policies. The degree of success of the implementation of the policy was variable and depended on the availability of tobacco and the type of mental health unit, but the smoke‐free policy provided an opportunity to reduce smoking and hence health inequalities for people with mental health problems.

This study aims to examine whether, in the opinion of patients selected in 13 hospitals of Hubei province, China, hospitals are smoke free. Patients were also asked whether their physicians had inquired about their smoking status.

Patients were recruited through an intercept method (i.e. stopped by the interviewer while in the hospital); data were collected through interviews, with a response rate of 96.1 percent.

Among the intercepted patients, 48.3 percent reported having seen people smoking in hospitals; 22.3 percent had seen a doctor and/or nurse smoking; 23.8 percent had smelled tobacco in hospitals; 68.4 percent reported having seen “no‐smoking” signs in hospital settings; 42.6 percent reported having been asked about smoking status in their latest visit to a doctor and 23.8 percent reported receiving tobacco cessation counseling. Compared to hospitals in large cities, patients from medium/small city hospitals reported significantly higher levels of cigarette smoking among physicians, and poorer implementation of regulations for a smoking‐free hospital, and less smoking cessation counseling by physicians.

Findings of this study point to the need for greater efforts to be made in promoting a smoke free environment in hospitals, as well as encouraging physicians to provide more smoking cessation counseling to smoking patients, particularly physicians in small and medium hospitals.

Prisoners are vulnerable to tobacco addiction and have a smoking prevalence significantly higher than that of the general community. The context of this study was the implementation of a “smoke-free prisons” policy, which imposed forced smoking cessation onto the Queensland, Australian prison population. The study asked the question: “What are the psychosocial processes in which male prisoners engage during smoking cessation in a smoke-free environment?”

Qualitative interviews were conducted with 15 prisoners in South-east Queensland smoke-free correctional centres. Grounded theory methodology was applied to construct a theory of the processes of smoking cessation.

The constructed theory was named Engaging with Quitting. In this model, prisoners proceed through a cycle of evaluations, adjustments and reflections on their reality as related to the smoke-free prison. The study gives first-hand accounts of the prisoners’ use (and abuse) of nicotine replacement therapy. Three personality typologies emerged from the data: The Angry Smoker, the Shifting Opportunist and the Optimistic Quitter.

This qualitative study makes no claim of generalisability and cannot be taken to represent all prisoners. Females, youths and culturally diverse prisoners were not represented in the sample.

Smoking cessation in prisons must be recognised as an ongoing process, rather than a discrete event. A coordinated approach between custodial and health authorities is required to minimise maladaptive coping strategies.

This study provides a descriptive account of the processes prisoners undertake during involuntary smoking cessation and has described the manner in which prisoners manufacture home-made tobacco from nicotine patches. The study has produced an original theory named Engaging with Quitting.

This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.

This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.

From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01).

A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.

This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.